THE FLOW FIELD AND MAIN GAS INGESTION IN A ROTOR-STATOR CAVITY Proceedings of GT2007 ASME Turbo Expo 2007: Power for Land, Sea and Air

ABSTRACT The ingestion of mainstream gas into turbine rotor-stator disk cavities and simultaneously, the egress of cavity gas into the main gas path are consequences of the prevailing unsteady, three-dimensional flow field. To understand these processes, we are carrying out a study that combines experiments in a model single-stage axial turbine with computational fluid dynamic (CFD) simulations. The turbine stage features vanes, blades, and axially overlapping radial clearance rim seal. In this paper, we present time-resolved velocity maps, obtained by particle image velocimetry, of the flow in the disk cavity at four experimental conditions as defined by the main air flow rate, rotor speed, and purge air flow rate. Time-averaged but spatially local measurement of main air ingestion is also presented. Significant ingestion occurred at two of the four experimental conditions where the purge air flow rate was lowit is found that high tangential (swirl) velocity fluid intersperses with lower tangential velocity fluid in the rim region of the cavity. It is argued that the high tangential velocity fluid is comprised of the ingested main air, while the lower tangential velocity fluid is the indigenous cavity air. This interpretation is corroborated by the results of the unsteady, three-dimensional CFD simulation. When the purge flow rate was high, no ingestion occurred as expected; also, large-scale structures that were unsteady appeared in the cavity flow giving rise to large velocity fluctuations. It is necessary to obtain time-resolved information from experiments and computation in such a flow because even when the vane-blade relative position is matched during a particular experiment, the instantaneous flow field does not necessarily remain the same. As such, some of the flow patterns will be smeared out if the interrogation time scale is large. NOMENCLATURE b outer radius of disk cavity

Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome. An international observational study

Objective: To compare the disease course in patients with mild Guillain-Barré syndrome (GBS) who were treated with intravenous immunoglobulin (IVIg) or supportive care only. Methods: We selected patients from the prospective observational International GBS Outcome Study (IGOS) who were able to walk independently at study entry (mild GBS), treated with one IVIg course or supportive care. The primary endpoint was the GBS disability score four weeks after study entry, assessed by multivariable ordinal regression analysis. Results: Of 188 eligible patients, 148 (79%) were treated with IVIg and 40 (21%) with supportive care. The IVIg group was more disabled at baseline. IVIg treatment was not associated with lower GBS disability scores at 4 weeks (adjusted OR (aOR) 1.62, 95% CI 0.63 to 4.13). Nearly all secondary endpoints showed no benefit from IVIg, although the time to regain full muscle strength was shorter (28 vs 56 days, p=0.03) and reported pain at 26 weeks was lower (n=26/121, 22% vs n=12/30, 40%, p=0.04) in the IVIg treated patients. In the subanalysis with persistent mild GBS in the first 2 weeks, the aOR for a lower GBS disability score at 4 weeks was 2.32 (95% CI 0.76 to 7.13). At 1 year, 40% of all patients had residual symptoms. Conclusion: In patients with mild GBS, one course of IVIg did not improve the overall disease course. The certainty of this conclusion is limited by confounding factors, selection bias and wide confidence limits. Residual symptoms were often present after one year, indicating the need for better treatments in mild GBS

Second IVIg course in Guillain-Barré syndrome with poor prognosis. The non-randomised ISID study

Objective To compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses. Methods From the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression. Results Of 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an α early' second IVIg course (1-2 weeks after start of the first IVIg course) and 18 patients a α late' second IVIg course (2-4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course. Conclusions This observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS